Q. Will there be a grace period after the Jan. 1, 2012, deadline to start using ANSI Version 5010 standards for electronic transactions? I am concerned about downtime after the changeover if the transition isn’t smooth.
A. Jan. 1, 2012, is a hard deadline. In fact, you could say the grace period is now. You are allowed dual use of existing standards (4010A1) and the new standards (5010) right up until the Jan. 1, 2012, compliance date.
Once you are prepared to send and receive 5010 transactions and any of your clearinghouses or payers are ready as well, you can begin to use the 5010 transactions with them if you mutually agree to this. This means you can avoid down time by working out all your 5010 transition kinks before the Jan. 1, 2012, deadline while you continue to file claims as usual.
For example, Medicare physicians are encouraged to contact TrailBlazer Health Enterprises now and facilitate testing to gain a better understanding of TrailBlazer testing protocols and the transition to 5010.
To help, the Center for Medicare & Medicaid Services will hold National 5010 Testing Day on Wednesday, June 15, 2011. National 5010 Testing Day is an opportunity for physicians, vendors, and clearinghouses to come together and test compliance efforts already under way, with the added benefit of real-time help desk support and direct, immediate access to TrailBlazer. Details concerning transactions to be tested are forthcoming from TrailBlazer. Keep an eye on TrailBlazer’s 5010 Information webpage.
For more help regarding the 5010 transition:
- Go to the TMA website for training opportunities.
- See the American Medical Association’s Transaction Code Set Standards page for fact sheets, FAQs, and more.
- Check the websites for each of your private payers to find testing tips, timelines, and training specific to them. Here are a few:
Published May 23, 2011
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